Systematic Changes in Families Following Prevention Trials
Abstract
A selective prevention design was applied to 238 recently separated families. Of these, 153 mothers randomly assigned to the experimental (E) group participated in 14 group sessions focused on Parent Management Treatment (PMT). Prior analyses showed that, over time, the group of families in the untreated group deteriorated in both parenting practices and in child outcomes. In keeping with the classic prevention pattern, families in the E group showed modest improvements in parenting and in child outcomes. Improvements in parenting were associated with significant reductions in problem behavior. The data showed that those mothers who improved their parenting skills during the first 12 months also showed significant reductions in maternal depression during that same interval. A cross-lagged panel analysis showed that a reduction in maternal depression during the first year of the study was a significant predictor of maintenance or improvements over the next 18 months. The findings are consistent with the concept of the family as a system.
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More than 50 experimental evaluations show that parents locked in a negative coevolutionary spiral with their children can learn a positive spiral involving high positive reinforcement for cooperation and mild, consistent negative consequences for noncooperation.
“More than 50 experimental evaluations demonstrate that parents locked in a negative coevolutionary spiral with their children can learn to adopt a positive coevolutionary spiral that involves providing high levels of positive reinforcement for cooperative behavior and mild, consistent negative consequences for uncooperative behavior (e.g., de Graaf et al. 2008; Nowak & Heinrichs 2008; Patterson et”
From Evolving the future: Toward a science of intentional change (2014) · cites this paper as Patterson et al. 2004
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Granic, I. (2000) · Emotion, Development, and Self-Organization · doi:10.1017/cbo9780511527883.012 · Cited by 72 · see citing works
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O'Connell, M., Boat, T., & Warner, K. (2009) · National Academies Press eBooks · doi:10.17226/12480 · Cited by 2,035 · see citing works
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“Although parental well-being is an important outcome, the effects of characteristics such as parental mental health and self esteem on child behaviors are frequently indirect effects, mediated by parenting practices (Capaldi et al. 2002; Conger et al. 1995; DeGarmo et al. 2004; Patterson et al. 2004).”
BackgroundPractitioner Review: What have we learnt about the causes of ADHD?
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“…changes in a wide range of psychological and physiological functions (de Kloet, Derijk, & Meijer, 2011; Lupien et al., 2009; Offidani & Ruini, 2012), resilience in this context is often not fully apparent until after the aversive circumstances have run their course (Masten & Narayan, 2012).”
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“Improvement in parenting practices has been shown to decrease child behavior problems (Eddy et al. 2005; Patterson et al. 2004), yet these interventions have not been evaluated in the CWS. Multidimensional Treatment Foster Care (MTFC) has been used with foster care providers to provide treatment to…”
BackgroundMethodCascading Effects Following Intervention
Patterson, G., Forgatch, M., & DeGarmo, D. S. (2010) · Development and Psychopathology · doi:10.1017/s0954579410000568 · Cited by 303 · see citing works
“Our passive longitudinal studies show a relation between maternal depression and disrupted parenting practices (Forgatch, Patterson, & Ray, 1996) and emphasize the relation between increasing success in the parent as being accompanied by the maternal sense of self-efficacy (Patterson et al., 2004).”
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“Although few intervention studies have documented that modifying maternal depressive symptoms accounts for intervention effects on child problem behavior (Patterson et al., 2004), there is large body of evidence demonstrating associations between maternal depression and multiple forms of child problem behav-”
BackgroundParenting Practices as Potential Mechanisms for Child adjustment Following Mass Trauma
Gewirtz, A. H., Forgatch, M. S., & Wieling, E. A. (2008) · Journal of Marital and Family Therapy · doi:10.1111/j.1752-0606.2008.00063.x · Cited by 254 · see citing works
“Data indicating the more direct influence of parenting practices, compared with caregiver functioning on child adjustment in stressful circumstances (DeGarmo et al., 2004; Patterson et al., 2004), provides further evidence for the need to investigate this path more closely among families following their exposure to ma…”
BackgroundSelf-citationEvolving the future: Toward a science of intentional change
Wilson, D. S., Hayes, S. C., Biglan, A., & Embry, D. D. (2014) · Behavioral and Brain Sciences · doi:10.1017/s0140525x13001593 · Cited by 255 · see citing works
Testing the Oregon delinquency model with 9-year follow-up of the Oregon Divorce Study
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“These mothers were most likely to show continued improvements in their parenting practices three years later (Patterson et al., 2004).”
BackgroundSelf-citationSocial Risk and Protective Child, Parenting, and Child Care Factors in Early Elementary School Years
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“To create a composite score for each construct, the strategy advised by Dishion et al. (1991) was used (see also Patterson et al. 2004; Webster-Stratton et al. 2001).”
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Muñoz, R. F., Beardslee, W. R., & Leykin, Y. (2012) · American Psychologist · doi:10.1037/a0027666 · Cited by 174 · see citing works
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Self-citationEarly-Starting Conduct Problems: Intersection of Conduct Problems and Poverty
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“Notable exceptions include recent studies by Eddy and Chamberlain (2000) and Patterson, DeGarmo, and Forgatch (2004) , who formally tested hypothesized mechanisms of change in selective parent-training interventions.”
BackgroundWithin-intervention change: Mediators of intervention effects during multisystemic therapy.
Deković, M., Asscher, J. J., Manders, W. A., Prins, P. J. M., & van der Laan, P. H. (2012) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0028482 · Cited by 109 · see citing works
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“There are no data among homeless families examining the contributions of parenting practices compared with caregiver functioning in influencing child adjustment (DeGarmo et al., 2004; Patterson et al., 2004).”
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“While studies such as those outlined above (e.g., Patterson et al. 2004) have been informative, they focus on interventions that are directed exclusively at parents.”
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BackgroundA randomized trial of group parent training: reducing child conduct problems in real-world settings.
Kjøbli, J., Hukkelberg, S., & Ogden, T. (2013) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.11.006 · Cited by 75 · see citing works
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“Moreover, several studies have shown interventions aimed at the family and the peer group to be effective in reducing antisocial behavior in children (e.g. Patterson et al. 2004 ).”
BackgroundHanisch, C., Freund-Braier, I., Hautmann, C., Jänen, N., Plück, J., Brix, G., Eichelberger, I., & Döpfner, M. (2009) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465809990440 · Cited by 69 · see citing works
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“Parenting intervention has two consequences, one to parents’ own wellbeing, and the other, to their children’s behavior (Patterson et al., 2004; Beauchaine et al., 2005; Robles and Romero, 2011).”
BackgroundFamily support programs and adolescent mental health: review of evidence
Kuhn, E., & Laird, R. (2014) · Adolescent Health, Medicine and Therapeutics · doi:10.2147/ahmt.s48057 · Cited by 60 · see citing works
“62,72 Child outcomes were more mixed – including reductions in 62,68,71 and no effects on 64,71 child behavior problems, no effects on child internalizing problems, 68,71 but improved child coping and mental and behavioral health and functioning.”
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MethodTesting a Military Family Stress Model
Gewirtz, A. H., DeGarmo, D. S., & Zamir, O. (2017) · Family Process · doi:10.1111/famp.12282 · Cited by 64 · see citing works
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Resilience in children and adolescents
Masten, A. S., Monn, A. R., & Supkoff, L. M. (2011) · Cambridge University Press eBooks · doi:10.1017/cbo9780511994791.009 · Cited by 49 · see citing works
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Cavaleri, M., Olin, S., Kim, A., Hoagwood, K., & Burns, B. J. (2011) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-011-0100-9 · Cited by 46 · see citing works
“Parent Management Training-Oregon Model (PMTO) DeGarmo et al. (2009), Patterson et al. (2004) 12.”
Bramesfeld, A., Platt, L., & Schwartz, F. W. (2006) · Health Policy · doi:10.1016/j.healthpol.2005.11.012 · Cited by 43 · see citing works
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“Interventions targeting one of the individual subsystems (i.e., the caregiver or child) may evoke changes in other (individual, dyadic, or triadic) subsystems (Patterson et al., 2004).”
BackgroundFeasibility of Implementation of a Parenting Intervention with Karen Refugees Resettled from Burma
Ballard, J., Wieling, E. A., & Forgatch, M. S. (2017) · Journal of Marital and Family Therapy · doi:10.1111/jmft.12286 · Cited by 44 · see citing works
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A Learning Theory Approach to Attachment Theory: Exploring Clinical Applications
Bosmans, G., Vlierberghe, L. V., Bakermans‐Kranenburg, M. J., Kobak, R., Hermans, D., & van IJzendoorn, M. H. (2022) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-021-00377-x · Cited by 53 · see citing works
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“The idea that changes in one parent can lead to changes in other members of the family is consistent with a family systems perspective, and has recently become the focus of study in PMTO research (Forgatch et al., 2009; Patterson et al., 2004).”
BackgroundResultSelf-citationMaternal Biomarkers of Acetaminophen Use and Offspring Attention Deficit Hyperactivity Disorder
Ji, Y.-L., Riley, A., Lee, L.-C., Hong, X., Wang, G.-Y., Tsai, H.-J., Mueller, N., Pearson, C., Thermitus, J., Panjwani, A., et al. (2018) · Brain Science · doi:10.3390/brainsci8070127 · Cited by 35 · see citing works
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“The findings extended those of Garber et al. (2011) by examining behaviorally observed negative parenting and replicated and extended the Patterson et al. (2004) findings by identifying differential outcomes for positive and negative parenting.”
Grimbos, T., & Granic, I. (2009) · Journal des adolescens · doi:10.1016/j.adolescence.2009.05.004 · Cited by 28 · see citing works
Health and Home Environments of Caregivers of Children Investigated by Child Protective Services
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“The vast majority of these studies has focused on changes in child functioning and has examined whether changes in parenting serve as a causal mechanism that produces changes in child behaviour (eg, DeGarmo, Patterson, & Forgatch, 2004 ; Patterson, DeGarmo, & Forgatch, 2004 ).”
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School outcomes of a community-wide intervention model aimed at preventing problem behavior.
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Dishion, T., & Snyder, J. J. (2004) · Journal of Abnormal Child Psychology · doi:10.1023/b:jacp.0000047317.96104.ca · Cited by 24
“As indicated by the careful analysis of intervention outcome research reported by Patterson and colleagues ( Patterson et al., 2004 ), the understanding of such dynamic patterns could lead to valuable predictions about how to jump-start a “cycle of change” that potentially amplifies over time to result in clinically s…”
BackgroundResultHenry, D., & The Multisite Violence Prevention Project (2012) · Prevention Science · doi:10.1007/s11121-011-0245-2 · Cited by 22 · see citing works
“As in prior mediation tests, these results suggest focusing on parenting and the family relationship in preventive intervention reduces problembehavior and presumably will decrease risk for later violence, particularly in comparison to non-intervention counterparts (Patterson et al. 2004).”
Evidence-based management of conduct disorders
Woolgar, M., & Scott, S. (2005) · Current Opinion in Psychiatry · doi:10.1097/01.yco.0000172057.71025.68 · Cited by 22 · see citing works
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“Our analyses adjusted for known risk factors of ADHD, but could not adjust for multiple parent-related factors identified in previous studies such as poor parenting [13,14], maltreatment [15], conflict/parent-child hostility [23], and severe early deprivation [24,25].”
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“improvements in secondary variables, such as parental depression (e.g., Hiscock & Wake, 2002; Kazdin & Wassell, 2000; Patterson, DeGarmo, & Forgatch, 2004 ) and parental stress (e.g., Kazdin & Wassell, 2000; Reid, Walter, & O’Leary, 1999), suggesting that these results may be more than an artifact.”
BackgroundDevelopmental transactions between boys' conduct problems and mothers' depressive symptoms.
Shaw, D., Gross, H. E., & Moilanen, K. L. (2009) · American Psychological Association eBooks · doi:10.1037/11877-005 · Cited by 19 · see citing works
Trouble Ahead: Predicting Antisocial Trajectories with Dynamic Systems Concepts and Methods
Lewis, M. D. (2004) · Journal of Abnormal Child Psychology · doi:10.1023/b:jacp.0000047214.03516.8b · Cited by 15
“Patterson et al. (2004) recognize the importance of an early therapeutic perturbation to maternal depression, shifting the dynamics of a system that would otherwise become increasingly entrenched.”
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“In the present study, mothers' and fathers' level of appropriate discipline, problem solving, and positive involvement were assessed and operationalized as in previous studies (DeGarmo & Forgatch, 2005; Ogden & Hagen; Patterson et al., 2004), whereas measures of monitoring and skill encouragement did meet acceptable l…”
MethodCluxton‐Keller, F., Riley, A. W., Noazin, S., & Umoren, M. V. (2015) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-015-0190-x · Cited by 18 · see citing works
“Although behavioral parent training programs delivered outside of primary care have shown reductions in parental depressive symptoms (e.g., DeGarmo et al. 2004; Patterson et al. 2004), this was not the primary goal of those interventions.”
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Prácticas de Crianza Positiva: Entrenamiento a padres para reducir Bullying
González, B. M., Cabrera, F., & Martínez, K. (2014) · Acta de Investigación Psicológica · doi:10.1016/s2007-4719(14)70980-9 · Cited by 12 · see citing works
“Patterson llamó a esto teoría de la coerción y propuso la necesidad de implementar programas para la reducción de problemas de conducta agresiva de niños a partir de la modificación de estrategias disciplinarias de los padres (Patterson et al., 2004; Pedroza, 2006).”
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Fatigue and physical activity: Potential modifiable contributors to parenting sense of competence
Studts, C. R., Pilar, M. R., Jacobs, J. A., & Fitzgerald, B. K. (2019) · Journal of Child and Family Studies · doi:10.1007/s10826-019-01470-0 · Cited by 10 · see citing works
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“Teaching parents to use positive reinforcement (attention and praise) for wanted behaviors and ignoring unwanted behaviors were adapted from Patterson Cognitive Behavioral Change theories and skills training methods developed to reduce psychopathology in children and families [40,41].”
Do Extremely Violent Juveniles Respond Differently to Treatment?
Asscher, J., Deković, M., van den Akker, A. L., Prins, P., & van der Laan, P. H. (2016) · International journal of offender therapy and comparative criminology · doi:10.1177/0306624x16670951 · Cited by 9 · see citing works
“To create a composite score for each construct, the following strategy was used (Patterson, DeGarmo, & Forgatch, 2004; Webster-Stratton et al., 2001): First, we selected the indicators (scales from established measures) for each construct.”
Shaffer, A., Lindhiem, O., & Kolko, D. (2013) · Journal of Emotional and Behavioral Disorders · doi:10.1177/1063426612462742 · Cited by 9 · see citing works
Fathers, Divorce, and Child Custody
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Flujas-Contreras, J. M., García‐Palacios, A., Castilla, D., & Gómez, I. (2023) · Current Psychology · doi:10.1007/s12144-023-05052-8 · Cited by 10 · see citing works
“The parent–child interactions, parenting styles, or beliefs about parental efficacy are risk or protective factors for developing and maintaining psychological disorders in childhood and adolescence (Newman et al., 2008, Patterson et al., 2004; Pinquart, 2017).”
Thijssen, J., Broers, N., Muris, P., & de Ruiter, C. (2018) · SAGE Open · doi:10.1177/2158244018763475 · Cited by 7
“Many studies rely on observations of parent–child interactions as a method to assess parenting skills (Martinez & Forgatch, 2001; Ogden & Amlund-Hagen, 2008; Patterson, DeGarmo, & Forgatch, 2004).”
Studying the Dynamics of Problem Behavior Across Multiple Time Scales: Prospects and Challenges
Howe, G. (2004) · Journal of Abnormal Child Psychology · doi:10.1023/b:jacp.0000047215.55438.0a · Cited by 7
“The first assumption concerning the importance of linear or curvilinear change over these time scales is well supported in these studies, which find evidence for systematic growth in externalizing behaviors through kindergarten and first grade (Hollenstein et al., 2004; Snyder et al., 2004), from middle to later child…”
BackgroundMethodResultInfluentialStoltz, S., van Londen, M., & Deković, M. (2015) · European Journal of Developmental Psychology · doi:10.1080/17405629.2015.1018172 · Cited by 6 · see citing works
“It is then not surprising that interventions that (also) focus on changing parenting are effective: Positive changes in maladaptive parenting behaviour can lead to positive changes in child behaviour (Patterson, DeGarmo, & Forgatch, 2004).”
The Impact of Poverty and Discrimination on Family Interactions and Problem Development
Lee, J., Biglan, A., & Cody, C. (2018) · Springer eBooks · doi:10.1007/978-3-319-94598-9_31 · Cited by 6 · see citing works
Benefits of Child Behavior Interventions for Parent Well-Being
Tømmerås, T., Kjøbli, J., & Forgatch, M. (2018) · Family Relations · doi:10.1111/fare.12344 · Cited by 5 · see citing works
Self-citationDanvers, A. F., Scott, B. G., Shiota, M., Tein, J., Wolchik, S., & Sandler, I. (2020) · Prevention Science · doi:10.1007/s11121-020-01142-2 · Cited by 3 · see citing works
Intervención interactiva en los problemas de comportamiento infantil.
Sierra, A. V., Alfaro-Belmont, J. N., Pérez, A. D. P., & García, D. A. M. (2015) · Acta Colombiana de Psicología · doi:10.14718/acp.2015.18.1.14 · Cited by 5 · see citing works
Homem, T., Gaspar, M., Santos, M., Azevedo, A., & Canavarro, M. C. (2014) · Journal of Child and Family Studies · doi:10.1007/s10826-014-9988-2 · Cited by 1 · see citing works
Day, J. J. (2016) · The University of Queensland · doi:10.14264/uql.2016.862 · Cited by 1 · see citing works
RETRACTED ARTICLE: Initial Validation of the Caregiver Wish List for Parenting Practices
Thijssen, J., & de Ruiter, C. (2011) · Journal of Child and Family Studies · doi:10.1007/s10826-011-9486-8 · Cited by 1
RetractedInterventionen bei expansivem Problemverhalten in der Grundschule
Hanisch, C., Eichelberger, I., Richard, S., & Döpfner, M. (2017) · Springer eBooks · doi:10.1007/978-3-658-07274-2_10 · Cited by 1 · see citing works
Evidence-Based Parenting Programs for School-Aged Children
Youssef, A. M., Garr, A., & Gewirtz, A. H. (2016) · Springer eBooks · doi:10.1007/978-3-319-12556-5_13 · Cited by 1 · see citing works
Fagan, A. A., & Benedini, K. M. (2016) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-016-0207-0 · Cited by 26 · see citing works
Maternal health habits and observed parenting behaviors in an autistic preschool sample
Johnson, M. G., Brassard, M. R., Jahromi, L. B., Greer, R. D., & Park, J. (2026) · Research in Autism · doi:10.1016/j.reia.2026.202902
Child Maltreatment and Maternal Childrearing Practices: Mediation by Parental Sense of Competence
Delhalle, M., & Blavier, A. (2026) · Journal of Child & Adolescent Trauma · doi:10.1007/s40653-025-00743-9
“In addition, we examined an alternative model, drawing from studies concerning the impact of parental management training (DeGarmo et al., 2004; Patterson et al., 2004), in which changes in maternal behavior are presumed to precede changes in PSC.”
Eşkisu, M., & Kapçı, E. G. (2021) · Türk psikoloji dergisi · doi:10.31828/tpd1300443320210103m000046
Ha, M. (2020) · doi:10.1080/03004430.2020.1730344
“Patterson, DeGarmo, and Forgatch (2004) stated that married couples who don’t receive social support from the people around them showed higher levels of conflict than those who received social support.”
BackgroundChildren's Adjustment after Parental Separation
Sweeper, S. (2012) · doi:10.1002/9781444354119.ch24
Strengthening Families Enrichment Program
Kumpfer, K., Xie, J., Magalhães, C., & Brown, J. (2019) · Encyclopedia of Couple and Family Therapy · doi:10.1007/978-3-319-15877-8_374-1
- Authors
- Patterson, G. R., DeGarmo, D., & Forgatch, M. S.
- Affiliations
- Oregon Social Learning Center (US)
- Corresponding author
- Patterson, Gerald R.
- Venue
- Journal of Abnormal Child Psychology
- Published
- 2004-12
- Volume
- 32
- Issue
- 6
- Pages
- 621-633
- ISSN
- 0091-0627 (ISSN-L)
- 1573-2835
- OpenAlex
- W2062739857
- Cited by
- 118
- References
- 54
- Citations by year
- 2026: 2 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 5 · 2018: 5 · 2017: 5 · 2016: 5 · 2015: 5 · 2014: 9 · 2013: 7 · 2012: 13
- FWCI
- 5.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Research on Child and Adolescent Psychopathology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (P50 MH46690, R01MH054703, P50MH046690, MH 38318, MH54703, R01MH038318)
- National Institute on Drug Abuse (R01DA016097, DA 16097)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Demography › Family Dynamics and Relationships
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- family prevention, parent training, child behavior problems, maternal depression, parenting practices, family systems, child outcomes, group intervention, maintenance of treatment effects
- MeSH terms
- Adult, Child, Child Behavior Disorders, Depressive Disorder, Family Therapy, Female, Humans, Male, Middle Aged, Models, Psychological, Mothers, Psychotherapeutic Processes, Single Parent, Multivariate Analysis, Likelihood Functions, Parenting, Pacific States, Self Efficacy
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